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Laryngeal Reconstruction Using Tissue‐Engineered Implants in Pigs: A Pilot Study
Author(s) -
Brookes Sarah,
Zhang Lujuan,
Puls Theodore J.,
Kincaid John,
VoytikHarbin Sherry,
Halum Stacey
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29282
Subject(s) - medicine , tissue engineering , cartilage , implant , laryngectomy , adipose tissue , stem cell , histology , larynx , anatomy , surgery , pathology , biomedical engineering , biology , genetics
Objective/Hypothesis There are currently no treatments available that restore dynamic laryngeal function after hemilaryngectomy. We have shown that dynamic function can be restored post hemilaryngectomy in a rat model. Here, we report in a first of its kind, proof of concept study that this previously published technique is scalable to a porcine model. Study Design Animal study. Methods Muscle and fat biopsies were taken from three Yucatan minipigs. Muscle progenitor cells (MPCs) and adipose stem cells (ASCs) were isolated and cultured for 3 weeks. The minipigs underwent a left laterovertical partial laryngectomy sparing the left arytenoid cartilage and transecting the recurrent laryngeal nerve. Each layer was replaced with a tissue‐engineered implant: 1) an acellular mucosal layer composed of densified Type I oligomeric collagen, 2) a skeletal muscle layer composed of autologous MPCs and aligned oligomeric collagen differentiated and induced to express motor endplates (MEE), and 3) a cartilage layer composed of autologous ASCs and densified oligomeric collagen differentiated to cartilage. Healing was monitored at 2 and 4 weeks post‐op, and at the 8 week study endpoint. Results Animals demonstrated appropriate weight gain, no aspiration events, and audible phonation. Video laryngoscopy showed progressive healing with vascularization and re‐epithelialization present at 4 weeks. On histology, there was no immune reaction to the implants and there was complete integration into host tissue with nerve and vascular ingrowth. Conclusions This pilot study represents a first in which a transmural vertical partial laryngectomy was performed and successfully repaired with a customized, autologous stem cell‐derived multi‐layered tissue‐engineered implant. Level of Evidence NA Laryngoscope , 131:2277–2284, 2021